More people are now playing sport and taking exercise regularly. This helps them to relax, enjoy their leisure and improve their general health and fitness. As a result, sports injuries are also more common. Fortunately many are not serious and, if treated properly and promptly, they heal quickly. Many injuries can be prevented by proper training, good technique and using the correct equipment.
What are the different types of injury?
Sporting injuries fall roughly into two categories:
- sudden or ‘acute’ injuries, e.g. a sprained ankle or torn muscle
- injuries caused by over-exercising, e.g. a runner’s sore foot or shin.
How can I prevent injury?
Some activities, such as golf and snooker, require skill rather than fitness. If you are taking part in one of the physically demanding sports, you should prepare and train gradually. This is important not only to improve performance but also to reduce the risk of injury. Exercise for both strength and endurance should also be balanced with rest. Tiredness can make injury more likely to happen.
Weight training increases muscle strength, and should ideally be started in a gym under supervision. Serious injuries to the spine and knees can come from incorrect lifting of heavy weights. Many gyms now have equipment which avoids the need to lift heavy, conventional weights, and allows more controlled strength training.
Should I warm up?
Muscles and tendons both work more efficiently when warmed up, and are then much less liable to injury. Be prepared to warm up and stretch your muscles for 10 minutes before training or competing. Always have a definite schedule for this.
A good technique is essential to improve performance and can also significantly reduce the chance of sustaining an injury. A coach, qualified in your sport, is the best person to give advice on technique, as well as on training and warming up.
The right equipment
Protective equipment such as helmets, gum shields and shin pads, along with comfortable and appropriate footwear all help prevent unnecessary injury. A qualified coach should be able to give you good advice on the best equipment available for your sport or activity.
As you get older there is a loss of muscle, but strength training, for example with weights in a gym under supervision, can prevent this. Keeping your muscles strong will also improve balance. Weight-bearing exercise such as walking, running and aerobics improves bone density which also falls as you get older. These measures can help prevent hip fractures. The general health benefits of exercise, perhaps more so in the elderly, mean that, overall, the risks of inactivity are greater than the risk of injury.
There are many positive advantages to keeping fit at all ages, but training and competitive sport must be tailored to both your individual capacity and your age. As you grow older you will be less able to make sudden, explosive movements; you will tend to be less supple and prone to tears of muscles and tendons. You will also be more likely to suffer from pain in the joints, back and neck. If you are older make sure you warm up with extra care.
Many ‘acute’ (sudden) injuries to joints, muscles, tendons and ligaments cause bleeding, swelling and pain. In these cases, treatment should be immediate so that healing can start as soon as possible. Unless the injury is very minor you should stop activity and apply first-aid treatment of ice and compression to the injured area. Ice and compression will help prevent bleeding and bruising of the injured tissue. The injured part of your body should be rested in a raised position, where practical.
For the first 24 hours after injury ice (or alternatively a packet of frozen peas) should be applied for 10 minutes at a time. A piece of wet towelling must always be placed between the ice pack and the skin so that the skin is not damaged by ice burns. A cold drinks can or cold running water can be used if ice or frozen peas are not immediately available. Avoid using ice for longer than 10 minutes at a time.
How can I avoid over-exercising?
If you push yourself too hard you can end up with what is known as an ‘over-use’ injury. This can be caused either by doing an activity you are not used to or by doing an excessive amount of an activity. Therefore it is important to build up gradually. The amount of activity that can be tolerated before an over-use injury happens varies from person to person. One of the most common problems is inflammation of the tendon sheaths around the wrist or ankle (tenosynovitis). Alternatively, the point where a tendon is attached to a bone may become painful. This could cause, for example, sore elbows in racket sport players or sore heels in runners. Occasionally over-use can cause ‘bone fatigue’ and stress cracks develop. This is one of several causes of sore shins in runners. The only effective treatment is adequate rest to allow healing. Anti-inflammatory drugs, splints or, rarely, injections may be used for the treatment of some over-use injuries. In addition, physiotherapists use a variety of techniques to treat these injuries. However, an adjustment to your training programme, technique or equipment can often help these injuries.
The body has a marvellous capacity to heal itself provided it is allowed to do so. This means that it is important not to return to full competition or activity until your injury is completely healed. In the very early stages, when there is a great deal of swelling and pain, you would be well advised to rest the affected area. Nevertheless, you must begin gentle movement and exercise of the injured part as soon as possible. This is usually after the first few days and once the swelling is under control.
Where possible, unless the injury is minor, it is important that any exercise of the injured area is under the supervision of a chartered physiotherapist. The exercises and movement you might be asked to do will be gradually increased but should never cause significant pain. The aim of exercises after injury is to restore the full range of movement, to help the injured part regain full strength and to recover the endurance of the muscles which may have been directly or indirectly affected by the injury. Balance exercises are also important, to restore control of the limb. These can be done using a balance board, which is particularly useful for ankle and knee injuries. Your physiotherapist will advise on the use of a balance board and any associated exercises.
For some injuries you may be advised to wear some kind of brace or strapping. It helps your injury to recover and also prevents it from recurring. These devices are available in sports shops but it is most important that the device is applied by an experienced person, such as a physiotherapist, in the first instance.
What is the physiotherapist’s role?
Any physiotherapist present when the injury takes place should be able to give valuable advice and treatment at an early stage. Physiotherapists help you regain full function of the injured part. They may also be able to advise you on how to stop that injury from happening again. There are now physiotherapists with a special interest in this area of work attached to sports injury clinics.
What is the doctor’s role?
The doctor’s job is to check whether your injury is serious enough to require medical, e.g. cortisone injections, or surgical treatment. The doctor can also arrange an X-ray or further specialised advice where necessary. Your doctor may prescribe painkillers or anti-inflammatory tablets when your injury is painful or very swollen. Some doctors, like some physiotherapists, have a special interest in sporting injuries and may be associated with athletic or other sporting clubs or sports injury clinics. Your doctor may also advise you on the treatment of overuse injuries and strains.
Important dos and don’ts
- Make sure you are physically fit and correctly equipped before you take part in sport. Warm up properly beforehand.
- Plan your training programme so that your activity is stepped up gradually. Take advice from a qualified coach or join a sports club.
- Do not continue your sport with a painful injured limb. Make sure you get proper and prompt treatment. Initially this may include rest, at least for the injured part.
- Make sure your injury has healed completely before returning to sport. Otherwise it may recur and you could develop a long-term injury.
- In planning your recovery, seek the advice of an experienced chartered physiotherapist to plan your exercise programme.
- In the early stage of your injury use ice for 10 minutes maximum. Make sure there is a towel between the ice and your skin.
- Do not massage or use heat on an acutely injured area within the first 48 hours.
- Make sure any supportive strapping is applied initially by an experienced person.
- When in doubt about the treatment of an injury, seek the advice of an experienced physiotherapist or doctor.